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Abstract: TH-PO262

Delta-He It Is a Novel Biomarker of Mortality in Prevalent Hemodialysis Patients: A Multivariate Regression Predictive Model Development 

Session Information

Category: Anemia and Iron Metabolism

  • 202 Anemia and Iron Metabolism: Clinical

Author

  • Sánchez, Manuel Benítez, Hospital Juan Ramon Jimenez, Huelva, Huelva, Spain
Background

Delta-He is a marker of iron availability, which has been suggested as a marker of the inflammation. It is calculated as the difference between the hemoglobin content of reticulocytes (Ret-He) reflects the incorporation of iron into the erythroid progenitor cells over the previous 2–4 days, and the hemoglobin content of erythrocytes (RBC-He). Under normal conditions, Delta-He has a positive value. As iron homeostasis and inflammation are related through the action of Hepcidin, an acute inflammatory response suppresses the availability of iron to erythropoietic progenitor cells and rapidly induces a decrease in Ret-He, leading to a negative value of Delta-He.

Methods


78 patients prevalent in Hemodialysis were followed during 1 year. We have analyzed time to the event (mortality from any cause ).Has been acknowledged Mortality as Dependente Variable and Delta-He Dicotomized as independent variable. Time in Hemodialysis , KtV, the treatment with erythropoiesis-stimulating agents (ESA) and Fe iv therapy was taken into account, PCR, RET-He and Delta-He . We have realise the determinations through the Sysmex XE 500. A survival study was carried out trougt using Multivariate Regression Cox Model . The predictive model is developed with the regression coefficients. Internal validity was realise by Bootstrap. The model is presented as a nomogram.

Results

22/78 patients (28.2%) presented exitus . 19/78 patients (24.4%) had Delta-He Negative and require a higher weekly dose of ESA. The delta He has a protective effect against mortality, that is, the greater the value of Delta-He, the less mortality, for each unit that increases Delta He above 0 the mortality decreases by 27%. Discrimination: Index C: 0.74, Calibration: I. Brier: 0.171, R2 Nagelkerke: 0.22.

Conclusion

Delta-He Negative is a predictive factor of all-cause mortality at one year in patients on hemodialysis, associated with inflammation and hypo-responsiveness to ESA.